by Erica Felci, The (Palm Springs, Calif.) Desert Sun

by Erica Felci, The (Palm Springs, Calif.) Desert Sun

RANCHO MIRAGE, Calif. -- When the Betty Ford Center outlined its vision for 2015, executives looked at international partnerships, an expanded children's program and a groundbreaking educational institute for medical professionals.

What wasn't in the cards - the former first lady and her daughter, then-board Chairwoman Susan Ford Bales, told The Desert Sun in 2007 - was building another center.

That vision is now being rewritten as the world-renowned drug and alcohol addiction treatment center merges with the Hazelden Foundation, a much larger program in Minnesota that's built its reputation by expanding into multiple states.

The new Hazelden Betty Ford Foundation, unveiled last week, will almost immediately focus on creating outpatient treatment centers across Southern California, particularly in dense populations like San Diego and Los Angeles.

Officials say it will provide an opportunity for addicts to undergo intense therapies without having to move to a residential program like the one in Rancho Mirage, which at one point this summer had less than 70 percent of its 160 beds full.

But it also means Ford's name will now be on treatment centers across the country.

"I do know the Betty Ford board and the Ford family strongly support the merger and strongly support this direction," said Mark Mishek, Hazelden's current president and CEO who will be in charge of the merged nonprofit.

"Every addiction provider struggles over time to fill beds. I would just say we'll be able to solve that problem."

The Hazelden Betty Ford Foundation will be the nation's largest nonprofit provider of addiction treatment programs.

After it clears regulatory review - a process that should be done by year's end - it will have 14 sites nationwide and an annual $180 million operating budget.

Mishek will move to the desert for up to six months, getting to know the staff and ultimately hiring someone to lead the Betty Ford Center on a day-to-day basis.

"It's going to be creating a new culture for the organization," he said.

One of the first priorities is a plan to create outpatient centers, where addicts could visit over several weeks without having to leave their homes or their jobs.

Mishek argued that the future of an isolated, freestanding treatment center, like the one Ford helped open in October 1982, is "not very good."

The new model will bring care into the community, with convenient evening and weekend hours and insurance-covered programs, "or they're not going to come," Mishek said.

"They are very effective. They have high rates," he said. "Not everyone needs residential care."

Filling a need

Estimates suggest that more than 23 million Americans are addicted to drugs or alcohol, but only 10 percent of them are seeking treatment.

The merger of Betty Ford and Hazelden was announced just a week before enrollment starts for the new federal Affordable Care Act, which ensures new benefits for mental health and substance use disorder services. Enrollment starts Tuesday.

"Suddenly, you are going to have many, many people who are going to be able to access services," Mishek said.

Betty Ford and Hazelden executives spent several months talking about the merger. But the relationship between the two industry powerhouses that focus on the 12-step program actually dates back decades.

Betty Ford's first and only CEO, the recently-retired John Schwarzlose, was working for Hazelden when Ford helped recruit him for the program she was starting in the Coachella Valley.

Hazelden also sent a handful of its employees to Rancho Mirage to help with the launch.

"Betty came over the first day to meet everybody," Schwarzlose is quoted as saying in Ford's autobiography, "Betty: A Glad Awakening."

"She was wearing her hard hat because the buildings were still being finished. She shook every staff member's hand, and let them know how important they were in her eyes."

Ford remained an active member of the board until 2005, when she handed the chairwoman role to her only daughter.

In a statement released by the Betty Ford Center, Bales insisted her mom would be pleased by the merger. But she did not respond to Desert Sun requests for comment last week.

"I'm excited that Mother's passion and vision for ensuring access to high quality treatment will be honored and expanded. Mother's and my focus will always be on the patients of addiction and alcoholism and their family members," Bales, trustee of the Elizabeth B. Ford Family Trust, said in Tuesday's statement.

"She would be pleased, as am I, with the Hazelden organization and its outstanding leadership team and staff, each of whom shares our focus."

The family's relationship with the treatment center has been strained since 2010, when divisions on the board over the center's potential expansions and day-to-day leadership forced Bales from the chairmanship.

She later left the board.

No family member has served on the center's board since Ford's death in July 2011. During that time, a number of donors told The Desert Sun they were pulling their financial commitments from the center, which is a $40 million a year operation.

Under the merger, the family trust can appoint two members to the Hazelden Betty Ford Foundation board, Mishek said.

Alumni and other members of the Betty Ford community who had sided with Bales during the 2010 dispute have been unusually mum since the merger was announced.

Sports television producer Geoffrey Mason, a normally outspoken former board member who spoke at Ford's funeral in Palm Desert, summarized his thoughts in a brief email.

"If this alliance results in better treatment - and more hope for more families - then I will be a huge supporter," Mason said.

Others were more skeptical.

Rose Marie Beaty, a retired government worker, said she went to Betty Ford Center twice, and then moved to Rancho Mirage so she could be closer to the center for continued support.

Over the years, she said she's also donated to the center and expressed great admiration for Ford. But last week, she said she was questioning whether she'd continue to give because the new group's name put Ford's name after Hazelden.

"I just don't understand the merger. But if it's gong to benefit more addicts, then I guess it's a good thing," Beaty said.

"I just don't see how that can be duplicated. I'm hoping in the long term, it will work out."

In Betty's name

Expanding outpatient services across Southern California mirrors the branding effort that Hazelden has pushed across other states.

It already has outpatient programs in Oregon, Minnesota, Illinois, Florida and New York. And Mishek has previously said there's been an immediate demand in each new location.

Although Mishek described residential treatment centers as a dated way of treating addiction, he insisted there are no plans to shut down the famed Rancho Mirage center.

The former first lady's name also will be added to signs at the centers nationwide.

"Betty Ford was a great person," Mishek said. "We did our market studies. We know how strong the name is."

Betty Ford Center Chairwoman Mary Pattiz declined to be interviewed for this story.

Even before Pattiz took the leadership post in 2010, board members had debated adding more locations and expanding its menu of programs. The center does have children's programs in Denver and Dallas.

In October 2007 - in what would be her last interview - Ford told The Desert Sun she opposed the idea of building more centers because it "would dissipate what we have here."

Under the merger, Mishek said there were no talks of expanding the programs to treat other addictions, which would allow them to compete with programs that cater to patients with gambling or sex addictions.

But the Hazelden Betty Ford Foundation will offer resources for addicts with co-occurring disorders such as anxiety.

"There are great programs out there. It's not going to be us," Mishek said about treating other addictions. "We're singularly focused."